Hi All,
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I have a question regarding kinetic wedges that has been bugging me for some time!!!!! :confused:
I understand that this modification to an orthoses is designed to place a cut out underneath the area of the 1st MPJ to reduce GRF and in turn allow the 1st MPJ a greater ability to dorsiflex in the latter stages of stance phase.
My ponderings are thus: I believe this forefoot modifications are generally made in conjunction with some rearfoot control, for arguments sake let it be a poly prop shell and 4 degree rearfoot varus wedge.
How much of the reduction in GRF under the 1st mpj comes from the rear/midfoot control, which could (again for the sake of argument) reduce the amount of pronation in the foot during gait, leaving the foot in a less pronated position after heel lift, thus reducing the GRF under the 1st MPJ and how much can possibly come from the Kinetic Wedge?
If the kinetic wedge works as it is proposed to work, would you see any benefit from just a simple, flat 5mm eva/polyprop plate, with a 1st mpj cut out and no rear foot control?
Is there any research showing reduction in pressure under the 1st MPJ, or perhaps an increase in 1st MPJ DF with the use of kinetic wedges added to a FFO vs a purely rear-midfoot control FFO?
Kind Regards,
Sam
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